short 4th / 5th metacarpal

Shortening of the fourth/fifth metacarpals and less commonly metatarsals is seen in a variety of apparently disparate conditions.

Pathology

Etiology

Common causes :

Uncommon causes :

Isolated shortening of the 5metacarpals has been recently described in a familial variant of type 1 diabetes mellitus .

Radiographic features

Plain radiograph

Hand x-rays readily identify the abnormality and can be assessed by drawing a line along the heads of the 4 and 5 metacarpals. If this line intersects the head of the 3 metacarpal then shortening is deemed to be present.

Thus, shortened 4 metacarpal is the key to this finding. It is known as the metacarpal sign. It is important to note that a positive sign can be seen in up to 10% of normal individuals .

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